Post-Surgery Concerns After Steel Nail Removal: Healing and Pain Management

Post-operative issues after hardware removal?

Hello Dr.
Chen! Last year, I had a femoral neck fracture in my right leg and had three steel pins implanted for stabilization.
After a year of recovery, my doctor assessed that the bone had healed well, and on August 25 of this year, the pins were removed.
Due to my osteoporosis, I was concerned about incomplete bone healing, so I requested my doctor to fill the bone defect with BMP (Bone Morphogenetic Protein) to promote proper bone growth.
After the sutures were removed post-surgery, the doctor informed me that there was no need for follow-up visits.

I would like to know if the addition of this material means I no longer need to worry about the healing of the defect.
However, for the past month since the surgery, I have been experiencing persistent pain around the wound area, with mild pain when sitting or walking for extended periods.
I am uncertain if this discomfort is related to the BMP material or if it is a rejection issue with my own bone.
Is this a normal reaction? I would prefer not to rely on pain medication continuously.
If I wish to schedule a follow-up appointment, how long would you recommend waiting before doing so? Thank you!

Chen, 30~39 year old female. Ask Date: 2023/09/30

Dr. Chen Bochen reply Orthopedics

Hello, there won't be any rejection issues with the BMP.
I recommend having an X-ray follow-up in two months.

Reply Date: 2023/09/30

More Info

Post-surgery concerns after the removal of steel nails, especially in the context of a femoral neck fracture, are quite common and can be multifaceted. It’s great to hear that your bone has healed well after a year and that you have undergone BMP (Bone Morphogenetic Protein) treatment to aid in the healing process. However, it’s understandable to have concerns about ongoing pain and the healing of the bone.

Firstly, it’s important to recognize that experiencing some pain after the removal of surgical hardware, such as steel nails, is not unusual. The pain you are feeling could be attributed to several factors:
1. Soft Tissue Healing: The surgery involves not only the bone but also the surrounding soft tissues, including muscles, tendons, and ligaments. These tissues can take time to heal and may cause discomfort as they recover.

2. Bone Remodeling: After the removal of the steel nails, your body will undergo a process called bone remodeling. This is where the bone adapts to the absence of the hardware and can lead to temporary discomfort as the bone structure adjusts.

3. BMP Material: The BMP material is designed to promote bone healing, but it can also lead to localized inflammation or discomfort as your body integrates it. While it is generally well-tolerated, some individuals may experience sensitivity or mild reactions to the material.

4. Activity Level: If you have resumed normal activities too quickly, this could also contribute to the pain you are experiencing. It’s crucial to gradually increase your activity level and listen to your body’s signals.

Regarding your concerns about the healing of the bone and the potential for rejection of the BMP material, it is generally rare for the body to reject BMP. However, if you notice significant swelling, redness, or increased pain, it would be advisable to consult your physician.

As for pain management, while it is understandable that you do not want to rely on pain medications long-term, it is essential to manage your pain effectively to facilitate rehabilitation. Non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful, but you should discuss any medication regimen with your doctor.

In terms of follow-up appointments, it is typically recommended to have a check-up around 6 to 8 weeks post-surgery, especially if you are experiencing ongoing pain. This allows your physician to assess your healing progress and address any concerns you may have. If the pain persists or worsens, it would be prudent to schedule an earlier appointment.

In summary, while some discomfort after the removal of steel nails is common, it’s essential to monitor your symptoms and maintain open communication with your healthcare provider. They can provide tailored advice based on your specific situation and help ensure that your recovery continues on the right track. Remember to take it easy, allow your body time to heal, and don’t hesitate to seek medical advice if you have concerns about your recovery.

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